(Illustration by Brant Day)

Mark G. Winiarski

Looking out and Looking in
Alumnus sees similarities between himself and his clients, the poor and disaffected of the Bronx.

by Mark Winiarski

My offices on Bainbridge Avenue in the Bronx face a "hot building," that is, one known for its drug commerce. From my window, I observe the teens and adults who linger nearby. They seem to be mainly idle, but actually they're buying and selling. When I leave at night, I don't even look at them, and I try not to think about whether they see me.

On first examination, my work as a psychologist with HIV-affected persons of color, largely drug users and their sexual partners, doesn't have any evident link to being a child of blue-collar parents in what was essentially a Polish village on the east side of Buffalo, N.Y.

The Bronx is 77 percent minority, but Bainbridge Avenue, a terminus of Irish migration, is a stew of recent ethnicity. In addition to the Irish, many Indians and Pakistanis help populate Bainbridge, post–Pol Pot Cambodians are not far away and Albanians have settled a mile or so south of the avenue.

In contrast, my Buffalo neighborhood was claustrophobia-inducing in its uniformity. My house, built for workers at 1901's Great Pan-American Exposition, was just blocks from the spires of St. Stanislaus Roman Catholic Church to the west and Corpus Christi Church to the northeast. The neighborhood surnames were jawbreakers like Krawczyk, Szczerbiak and Ziolkowski.

Different, yes, but actually, this very insularity bred many similarities to the Bronx. My father and mother, children of immigrants, believed and taught that we were imperiled "outsiders," separated by class and ethnicity from all others. Most were better than we were, they taught. At the threshold of a downtown store, my mother told her boy that we couldn't go in because it was for "better people."

Threatened by the more advantaged, we also were threatened by the less advantaged. A wave of alarm would skip from front yard to front yard when the courageous or uninformed black person, openly called a nigger in the 1950s, walked from Fillmore Avenue down Peckham Street. These many years later, it is obvious that the real threat was in the Polish community's soul — frightened, self-loathing and unconsciously self-destructive.

I recall my own hostility as I sat in an airport lounge one day in the early 1970s and watched a trio of buttoned-down, chino-clad preppies. Enraged at being an outsider to their seemingly easy privilege, I wanted to smash their faces. It was a constant, that rage, even though no one called me a nigger or treated me like one.

These memories actually have been a disguised gift. In my mid-30s, I became a psychology intern at Bellevue Hospital. Although I was a straight male, I found myself resonating with the "outsider" experience of gay men who had contracted HIV.

In the Bronx, I discern the feelings about the very real and serious racism that is embedded in the lives of persons of color in the United States. Minority-culture parents and children have great reservoirs of rage at the educational, governmental and medical systems that are in fact white systems, requiring assimilation. Health care typically is a fusion of white and biomedical cultures, which overlook many aspects of minority life: a tragic fatalism that hinders preventive care, an occasional reliance on culturally appropriate alternative remedies and the major role of spirituality in healing.

As for drug takers, heroin use from my perspective has the same psychological roots as that of another psychic anesthetic, alcohol. One is used by persons in the Bronx who have endured years of trauma with no end in sight. Where I grew up, surrounded by bars, alcohol was used by factory workers and the unemployed —angry, anxious and without meaning to their lives.

Psychoanalysts, those searchers for deep understanding, believe that underlying every action, there are always self-centered motives.

So, from my window, I watch the young black and Latino men who may or may not be watching me. On a daily basis I make many distinctions between the consumers of my services and myself, but all the distinctions are superficial and, ultimately, insignificant. We are not all that different. When I create programs to care for the mental health of HIV-positive persons in the Bronx, I am not taking care of others. I am taking care of myself.

Mark G. Winiarski (J72), a former journalist who became a clinical psychologist, directs two federally funded HIV mental health projects at Montefiore Medical Center in the Bronx, N.Y.